<script type="text/javascript">
    var authenticityToken = '<%=  form_authenticity_token %>'
    var hospiceId = '<%= session[:hospice_id]%>'
</script>
<%=javascript_include_tag("patients/view.js") %>
<body class="yui-skin-sam">
  <div id="container">
    <div id="head">
      <div id="logo">&nbsp;</div>
      <div id="userinfo">
        <%=session[:hospice_name]%><br><%=session[:user_name]%>
      </div>  
    </div>
    <div id="sidebar" class="yuimenu"></div>
    <div id="content">
      <div id="grid">
        <div id="xml"></div>
      </div>
      <div id="functions">
        <input type="button" id="btnAddPatient" name="btnAddPatient" value="Add Patient"/>
      </div>
      <div id="detail">
        <div id="patient_details" class="yui-navset"></div>
      </div>
    </div>
  </div>
  <div id="addPatient">
    <div class="hd"></div>
    <div class="bd">
      <table>
        <tr>
          <td>First Name:</td>
          <td><input type="text" id="txtFirstName" class="requiredField"/></td>
        </tr>
        <tr>
          <td>Last Name:</td>
          <td><input type="text" id="txtLastName" class="requiredField"/></td>
        </tr>
        <tr>
          <td>Date of Birth:</td>
          <td><%= date_select :patient, :birth_date, :class=>"requiredField", :start_year => 1900 %></td>
        </tr>
        <tr>
          <td>Race:</td>
          <td><%= collection_select("patient", "race", @races, "id", "race_description") %></td>
        </tr>
      </table>
    </div>
    <div class="ft">
      <input type="button" id="btnSave" value="Save"/><input type="button" id="btnCancel" value="Cancel"/>    
    </div>
  </div>
</body>